scholarly journals Hypouricemic agents reduce indoxyl sulfate excretion by inhibiting the renal transporters OAT1/3 and ABCG2

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tetsuya Taniguchi ◽  
Koichi Omura ◽  
Keisuke Motoki ◽  
Miku Sakai ◽  
Noriko Chikamatsu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
The Body ◽  
Proximal Tubules ◽  
Indoxyl Sulfate ◽  
Minimal Effect ◽  
Renal Transporters ◽  
Urate Reabsorption ◽  
Intact Rats

AbstractIndoxyl sulfate (IS) accumulates in the body in chronic kidney disease (CKD). In the renal proximal tubules, IS excretion is mediated by OAT1/3 and ABCG2. These transporters are inhibited by some hypouricemic agents; OATs by probenecid and benzbromarone, ABCG2 by febuxostat and benzbromarone. Thus, we evaluated whether hypouricemic agents including dotinurad, a novel selective urate reabsorption inhibitor with minimal effect on OATs or ABCG2, affect IS clearance in rats. Intact and adenine-induced acute renal failure rats were orally administered hypouricemic agents, and both endogenous IS and exogenously administered stable isotope-labeled d4-IS in the plasma and kidney were measured. Our results demonstrated that OATs inhibitors, such as probenecid, suppress IS uptake into the kidney, leading to increased plasma IS concentration, whereas ABCG2 inhibitors, such as febuxostat, cause renal IS accumulation remarkably by suppressing its excretion in intact rats. The effects of these agents were reduced in adenine-induced acute renal failure rats, presumably due to substantial decrease in renal OAT1/3 and ABCG2 expression. Dotinurad did not significantly affected the clearance of IS under both conditions. Therefore, we suggest that hypouricemic agents that do not affect OATs and ABCG2 are effective therapeutic options for the treatment of hyperuricemia complicated by CKD.

HIV-associated kidney disease in the context of an aging population

Sexual Health ◽  
2011 ◽  
Vol 8 (4) ◽  
pp. 485 ◽  
Author(s):  
Claire Naftalin ◽  
Bavithra Nathan ◽  
Lisa Hamzah ◽  
Frank A. Post
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Risk Factor ◽  
Antiretroviral Therapy ◽  
Kidney Disease ◽  
General Population ◽  
Life Expectancy ◽  
Hiv Care ◽  
Developed World

Acute renal failure and chronic kidney disease are more common in HIV-infected patients compared with the general population. Several studies have shown age to be a risk factor for HIV-associated kidney disease. The improved life expectancy of HIV-infected patients as a result of widespread use of antiretroviral therapy has resulted in progressive aging of HIV cohorts in the developed world, and an increased burden of cardiovascular and kidney disease. Consequently, HIV care increasingly needs to incorporate strategies to detect and manage these non-infectious co-morbidities.

CONSERVATIVE MANAGEMENT OF ACUTE RENAL FAILURE

PEDIATRICS ◽  
1960 ◽  
Vol 25 (3) ◽  
pp. 409-418
Author(s):  
S. A. Kaplan ◽  
J. Strauss ◽  
A. M. Yuceoglu
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Fluid Intake ◽  
Sodium Intake ◽  
Caloric Intake ◽  
Urine Volume ◽  
Proximal Tubules ◽  
Cation Exchange Resins ◽  
Exchange Resins ◽  
Insensible Loss

The observations during treatment of three children with acute renal failure by a conservative regimen of therapy are presented. One patient died. The regimen has also been applied to six adults with renal failure; one died. The urine in the early stages of renal failure may be iso-osmotic with plasma and may represent unmodified fluid from the proximal tubules. Cardiac failure associated with hyperkalemia or administration of excessive quantities of fluids is the most frequent cause of death in this disorder. A regimen of therapy is described which embodies the following principles: a) Limitation of daily fluid intake to insensible loss plus the urine volume of the previous day. b) Restriction of sodium intake from the beginning to anticipate the development of acidosis. c) Use of cation exchange resins to prevent excessive increase in the concentration of potassium in the serum. d) Provision of adequate caloric intake through the administration of emulsified fat intravenously. e) Treatment of hyperphosphatemia and hypocalcemia when they occur. f) Continuation of careful supervision and therapy, even after the diuretic phase begins, since renal function continues to be severely restricted for several days afterwards.

Anaesthesia of the patient with chronic kidney disease

2020 ◽  
Vol 25 (11) ◽  
pp. 268-276
Author(s):  
Oscar Bautista Díaz-Delgado ◽  
Briony Alderson
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Cardiac Output ◽  
Kidney Disease ◽  
The Body ◽  
Renal Physiology ◽  
Successful Management ◽  
Emergency Procedures ◽  
Routine Procedures

Chronic kidney disease is common, particularly in geriatric animals. General anaesthesia is usually required for routine procedures (dental prophylaxis, ovariohysterectomy or castration) and emergency procedures, which may have profound effects on the body, especially on cardiac output, subsequent blood pressure and on the perfusion of different vital organs. It is essential to understand the effects of renal dysfunction on the patient, as well as the effects that anaesthesia and surgery may have on the kidneys. The understanding of renal physiology, along with the effect of drug choices, is key to successful management of chronic renal failure.

Ischemia-induced cleavage of cadherins in NRK cells requires MT1-MMP (MMP-14)

2006 ◽  
Vol 290 (1) ◽  
pp. F43-F51 ◽  
Author(s):  
Marisa D. Covington ◽  
Robert C. Burghardt ◽  
Alan R. Parrish
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Matrix Metalloproteinase ◽  
Protein Expression ◽  
Neutralizing Antibody ◽  
Proximal Tubules ◽  
High Morbidity ◽  
Chemical Inhibitors ◽  
Membrane Type

Ischemia is a leading cause of acute renal failure (ARF), a disease associated with high morbidity and mortality. Disruption of intercellular adhesion in the proximal tubules is linked to ARF, although the molecular mechanism(s) remains unclear. Our previous studies showed that ischemia is associated with cadherin cleavage and loss in NRK cells, putatively due to a matrix metalloproteinase (MMP) ( 7 ). In the current studies, a MMP required for E-cadherin cleavage and N-cadherin loss was identified. Chemical inhibitors against a number of soluble MMPs ( 1 , 2 , 3 , 8 , 9 ) failed to completely attenuate ischemia-induced cadherin loss. Under ischemic conditions, there was an increase in active membrane-type (MT)1-MMP but a decrease in MMP-2 protein expression. Plating cells on fibronectin protected against ischemia-induced loss of cadherins and, interestingly, no increase in active MT1-MMP levels was seen in ischemic cells on fibronectin-coated dishes. In addition, L cells stably expressing E- (LE) or N-cadherin (LN), but lacking MT1-MMP expression, were resistant to ischemia-induced cadherin loss. The role of MT1-MMP in ischemia-induced cadherin loss was confirmed by either blocking MT1-MMP activity with a neutralizing antibody or expression with shRNA constructs which protected full-length E- and N-cadherin during ischemia. Using shRNA constructs to suppress MT1-MMP expression, ischemia-induced disruption of cadherin function was ablated, and cell-cell contacts were preserved. These results demonstrate that ischemia induces increased expression of active MT1-MMP and subsequent disruption of cadherin/catenin complexes, implying that MT1-MMP plays a role in ischemia-induced ARF.

Involvement of Indoxyl Sulfate in Renal and Central Nervous System Toxicities During Cisplatin-induced Acute Renal Failure

2007 ◽  
Vol 24 (4) ◽  
pp. 662-671 ◽  
Author(s):  
Kazufumi Iwata ◽  
Hiroshi Watanabe ◽  
Takafumi Morisaki ◽  
Takanobu Matsuzaki ◽  
Takafumi Ohmura ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Renal Failure ◽  
Nervous System ◽  
Acute Renal Failure ◽  
Indoxyl Sulfate

scholarly journals A brief grief over bowel relief

F1000Research ◽  
2013 ◽  
Vol 2 ◽  
pp. 26 ◽  
Author(s):  
Kamalpreet S Parmar ◽  
Malvinder S Parmar
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Kidney Disease ◽  
Bowel Preparation ◽  
Sodium Phosphate ◽  
Careful Monitoring ◽  
Oral Sodium Phosphate ◽  
Oral Sodium

Oral sodium phosphate (OSP) solution is commonly used as bowel purgative before colonoscopy. Its safety has recently been questioned with several reports of acute renal failure and chronic kidney disease following its use. All of the cases reported are following bowel preparation for colonoscopy. I present a case of acute renal failure following OSP solution given to relieve constipation. This report further highlights the dangers of OSP and the importance of caution and careful monitoring when OSP solution is used as a cathartic, or for bowel preparation before colonoscopy.

Renal disease

2018 ◽  
Author(s):  
Quentin Milner
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Renal Disease ◽  
Replacement Therapy ◽  
Impaired Renal Function ◽  
Anaesthetic Management

This chapter describes the anaesthetic management of the patient with renal disease. The topics include estimation of renal function, chronic kidney disease, renal replacement therapy (including haemodialysis), acute renal failure, and the patient with a transplanted kidney. For each topic, preoperative investigation and optimization, treatment, and anaesthetic management are described. The effects of impaired renal function on the elimination of anaesthetic drugs are discussed.

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